Clinical Significance Of 24h Ambulatory Blood Pressure Monitoring In Assessment Of Blood Pressure Level And Cardio-cerebro Vascular Risk In Treated Patients With Essential Hypertension

Objective:To explore the clinical value of 24 h ambulatory blood pressure monitoring(ABPM)in assessment of blood pressure level after taking medicine and cardio-cerebro vascular risk in patients with essential hypertension.Methods:1. A total of 172 essential hypertension patients who taking losartan potassium or benzene sulfonic acid L amlodipine were selected. The office and ambulatory blood pressure were compared between patients with different drugs, and the control rates for ambulatory blood pressure were analysed in patients with controlled and uncontrolled office blood pressue.2. According to the occurrence of cardiovascular events during follow-up,patients were divided into endpoint group and without endpoint group to analyse the correlation of ambulatory blood pressure with cardio-cerebro vascular events risk.Results:1. 24 h mean systolic blood pressure(24h MSBP) of patients with losartan potassium was lower than that with benzene sulfonic acid L amlodipine[( 125.35±11.06) vs(130.49±7.68)mm Hg,P<0.05], while there was no statistical significance in office blood pressure(P>0.05).2. The control rates of office blood pressure and ambulatory blood pressure were not consistent.In 59 patients with controlled office blood pressure,17 cases(28.8%) were not up to the standard of ambulatory blood pressure.3. Compared with patients without cardio-cerebro vascular events,patients with events were older[(68.27±11.10)vs(59.92±13.35)years], with longer duration[(11)vs( 5.2) years], and with lower office diastolic blood pressure[( 74.88±12.27)vs( 84.95±11.86) mm Hg] and 24 h mean diastolic blood pressure(24h MDBP)[(71.23±9.61) vs(77.75±9.25)mm Hg], all P<0.05.4. Binary logistic regression analysis showed that risk of cardio-cerebro vascular events in patients with office diastolic blood pressure≤70 mm Hg was higher than that of office diastolic blood pressure≥90 mm Hg(OR=9.778,95%CI 1.890-50.591),and risk of cardio-cerebro vascular events in patients with 24 h MDBP ≤70 mm Hg was higher than that of 24 h MDBP ≥80 mm Hg(OR=3.094,95%CI 1.095-8.742).5. Multivariate logistic regression analysis showed that office diastolic blood pressure and 24 h MDBP were lack of significant independent correlation with cardio-cerebro vascular events occurrence risk.Conclusion:1. The comprehensive evaluation of blood pressure level after taking medicine and cardio-cerebro vascular events occurrence risk of EH patients should be combined with24 h ABPM.2. Office diastolic blood pressure and 24h-MDBP were related factors of cardio-cerebro vascular events occurrence risk in patients with EH,but which has not reached the leval of independent prediction.